| NPI | 1104091297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: HI MD-18417) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CO 49965) |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2015-12-11 |